NPIMap

Individual provider Active NPI

Michelle Gonzalez

  • Medical Physician Assistant
  • Concord, MA
National Provider Identifier
1588373203
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA8922 Issued in MA
Practice address
2284 Main St
Concord, MA 01742-3829
Phone
(978) 369-5575
NPI assigned
Nov 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA8922 MA Primary

Addresses

Primary practice location

2284 Main St
Concord, MA 01742-3829

Mailing address

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

Other practice location 1

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230223001978 MA Practitioner - Physician Assistant 9931572849 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medical Associates-EbnhcGroup PAC ID 6103814371, 239 clinicians

Practice addresses (Care Compare)

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA8922MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 13, 2023 Accepting new patients
Neighborhealth Corporation Current Accepting new patients
Neighborhealth Corporation Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1588373203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2284 MAIN ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423829",
            "telephone_number": "978-369-5575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Gove St",
            "address_purpose": "LOCATION",
            "city": "East Boston",
            "state": "MA",
            "postal_code": "021281920",
            "country_code": "US",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA8922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.